LETTER TO THE EDITOR
Department of Urology, Numune Education and Research Hospital, Ankara, Turkey
Int Braz J Urol, 33: 216222, 2007
To the Editor:
Authors investigated the prevalence of nocturnal enuresis and associated factors of enuresis in Turkish children. The response rate was 89% and overall prevalence of nocturnal enuresis and diurnal enuresis were 17.5% and 1.9%, respectively. Some factors were associated with enuresis. They concluded that the prevalence of nocturnal enuresis in Turkish children was not different form others and that families do not have sufficient attention about enuresis.
First of all, it is hopeful to follow the standardization of terminology of lower urinary tract function in children and adolescents 1, to make it easier to compare studies and decrease confusion among researchers. The report 1 recommended that the ambiguous term diurnal enuresis should be avoided. Second, when conducting a questionnaire survey, it must be important to use a validated and reliable questionnaire. The major problem, here, is whether the questionnaire was a validated and reliable one or not, to evaluate lower urinary tract symptoms in children. Most of the questionnaire surveys have the same drawbacks as this one: the use of unvalidated questionnaires and no comparative data. Sureshkumar et al. reported the validity and reliability of a questionnaire 2.
Third, there is no consensus about a simple question that should complete the questionnaire; parents, children or both? In general, it is not so straightforward to evaluate nocturnal enuresis and overactive bladder symptoms accurately in children. For children, it is too difficult to assess the presence of urgency and to count the episodes of nocturnal enuresis and the frequency of daytime voiding. On the other hand, as authors concluded, parents may be unable to report their child's frequency of daytime voiding, presence of urgency and incontinence, and even episodes of nighttime urinary incontinence until they have a chance to observe the child at home and complete a bladder diary. A bladder diary could be an important adjunctive measure to objectively assess these and other parameters.
In conclusion, terminology and a bladder diary could be a useful tool when a questionnaire survey about lower urinary tract symptoms in children was conducted.
References
1. Neveus T, von Gontard A, Hoebeke P, Hjalmas K, Bauer S, Bower W, et al.: The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children's Continence Society. J Urol. 2006; 176: 31424.
2. Sureshkumar P, Cumming RG, Craig JC: Validity and reliability of parental report of frequency, severity and risk factors of urinary tract infection and urinary incontinence in children. J Urol. 2006; 175: 225462.
Dr. Mitsuru Kajiwara
Department of Urology
Division of Frontier Medical Science
Hiroshima University, Hiroshima, Japan
Email: urokajiwara@yahoo.co.jp
Re: Prevalence and associated factors of enuresis in Turkish children.
Publication Dates
-
Publication in this collection
29 Aug 2007 -
Date of issue
June 2007